Individual
MIA POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 704-2900
Mailing address
2031 PAUL QUINN ST, HOUSTON, TX 77091-5435
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
1075205
TX
Other
Enumeration date
04/17/2022
Last updated
04/17/2022
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